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General NPI Number Information
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NPI Number | 1871021386
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Entity Type | Individual
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Provider Name | MEAGHAN REANEY DO
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Gender | Female
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Dates
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Enumeration Date | 05/28/2017
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Last Update Date | 09/21/2022
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Provider Practice Location Address
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Address Line | 4855 S MOORLAND RD
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City | NEW BERLIN
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State | WI
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Zip | 53151-7494
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Country | US
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Telephone | 262-432-7599
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Fax |
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Provider Business Mailing Address
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Address Line | 7572 S KENT ST
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City | FRANKLIN
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State | WI
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Zip | 53132-2172
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Country | US
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Telephone | 708-743-5812
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | DO-05600
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 75392-21
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License Number State | WI
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